2025 PLSI Laptop Reimbursement Form | AILC • American Indian Law Center, Inc.

Eligibility – 2025 Pre-law Summer Institute (PLSI) participants who need a laptop to fully participate in the program are eligible for the 2025 PLSI Laptop Reimbursement up to $1300. You must submit an original receipt showing the laptop purchased and the amount that YOU paid. Receipts that show non-PLSI participant’s name (Ex: Family member, significant other, etc..) will NOT be accepted.

Name *

First

Last

Email *

Current Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Explanation of Need *

Examples: current laptop is too old, no laptop at all, current laptop is incompatible with law school use, can no longer use shared device, etc.

Type of Laptop Purchased *

Amount Paid *

Did you receive a scholarship, grant, donation, or other price reduction for the purpose of paying for this device? *

Yes
No

Please indicate name of source(s) and/or donor(s) and amount(s) received for each award and date of award:

Source or donor: *

Amount *

Date *

Certification and Acknowledgment of Responsibility *

I certify that I need this device to participate in the 2025 PLSI program and to the best of my knowledge the information contained in this application is true. I read and understand the PLSI 2025 laptop reimbursement guidelines. I understand that any misrepresentation on this application and attachments could be cause for a dismissal from the program and misconduct investigation. By accepting this reimbursement, I also certify that I will use this device to participate in the 2025 PLSI program and that if I am removed from or leave the program for any reason, I will return the full amount of this reimbursement to the AILC within 30 days.

Signature *

Clear Signature

Sign by drawing your digital signature in the box above.

Paid and/or date

Today's Date *